Toy Serkan, McKay Robert Sf, Walker James L, Johnson Scott, Arnett Jacob L
Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Wichita, KS, USA.
J Med Educ Curric Dev. 2017 Mar 15;4:2382120516684829. doi: 10.1177/2382120516684829. eCollection 2017 Jan-Dec.
To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion.
The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students' procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively.
In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( < .001). Paired-samples tests indicated statistically significant improvement in knowledge scores for intubation, (23) = -2.92, < .001, and arterial line placement, (23) = -2.75, < .001. Procedural performance scores for intubation ((23) = -17.29, < .001), arterial line placement ((23) = -19.75, < .001), lumbar puncture ((23) = -16.27, < .001), and central line placement ((23) = -17.25, < .001) showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures.
The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students' written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.
评估以学习者为中心的模拟培训的效果,该培训旨在帮助医学生提高插管、动脉置管、腰椎穿刺和中心静脉置管等操作技能。
研究参与者为二年级和三年级医学生。麻醉科住院医师提供培训并评估学生的操作技能。每个站点有两名住院医师,对轮转通过所有4个站点的医学生进行培训。分别使用调查问卷、多项选择题测试和操作检查表对培训前后的信心、知识和操作技能进行评估。
总共24名学生参加了6次4小时的培训课程。学生报告称,培训后在对真实患者进行所有4项操作时自信心显著增强(<.001)。配对样本检验表明,插管知识得分((23) = -2.92,<.001)和动脉置管知识得分((23) = -2.75,<.001)有统计学意义的显著提高。插管操作表现得分((23) = -17.29,<.001)、动脉置管操作表现得分((23) = -19.75,<.001)、腰椎穿刺操作表现得分((23) = -16.27,<.001)和中心静脉置管操作表现得分((23) = -17.25,<.001)均有显著提高。组内相关系数表明所有操作检查表得分具有高可靠性。
模拟课程使每名医学生在每项操作中都能得到两名住院医师的个别指导。学生的书面评论表明这种培训方式很受欢迎。结果显示,医学生在上述操作中的自信心、知识和技能均有所提高。